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Sistem pengelolaan asuhan keperawatan di poliklinik rawat jalan Simatupang, Yesi Juniarta; Hariyati, Roro Tutik Sri; Wildani, Andi Amalia
Holistik Jurnal Kesehatan Vol. 19 No. 2 (2025): Volume 19 Nomor 2
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i2.841

Background: Nursing care management in outpatient units is an important aspect in improving the quality of hospital services. Nursing care is a critical thinking model that is patient-centered and based on a systematic approach starting from assessment, diagnosis, planning, implementation, and evaluation. However, in Indonesia the achievement of nursing care implementation is still not optimal, which is 56.8%. Purpose: To describe the implementation of the nursing care system in outpatient polyclinics. Method: The pilot project carried out included problem identification, problem analysis, determining problem priorities, preparing a Plan of Action (POA), implementation, and evaluation, which was carried out at X hospital Jakarta on September 2-October 2, 2024. Data collection was carried out through interviews, observations, and surveys, then the data was analyzed using strengths, weaknesses, opportunities, and threats (SWOT) analysis. Results: Evaluation showed that 60% of nursing care documentation met quality standards with a 5% increase in knowledge after implementation. Conclusion: Continuous audit improvement and training development are needed to support the implementation of changes. This continuous evaluation is needed to ensure that quality improvements can be maintained and continue to develop. Suggestion: Concrete steps needed are to conduct monthly evaluations of documentation implementation to ensure nursing care is carried out according to standards. Keywords: Audit; Change; Nursing Care; Outpatient. Pendahuluan: Pengelolaan asuhan keperawatan di unit rawat jalan merupakan aspek penting dalam meningkatkan kualitas pelayanan rumah sakit. Asuhan keperawatan adalah model berpikir kritis yang berpusat pada pasien dan didasarkan pada pendekatan sistematis mulai dari pengkajian, penetapan diagnosis, perencanaan, implementasi, dan evaluasi. Namun, di Indonesia pencapaian pelaksanaan asuhan keperawatan masih belum optimal, yaitu sebesar 56.8%. Tujuan: Untuk mendeskripsikan implementasi sistem pengelolaan asuhan keperawatan di poliklinik rawat jalan. Metode: Pilot project terdiri dari identifikasi masalah, analisis masalah, penetapan prioritas masalah, penyusunan Plan of Action (POA), implementasi, dan evaluasi, dilaksanakan di RS X di Jakarta pada tanggal 2 September- 2 Oktober 2024. Data dikumpulkan melalui wawancara, observasi, dan survey, kemudian data dianalisis dengan menggunakan analisis strengths, weaknesses, opportunities, dan threats (SWOT). Hasil: Evaluasi menunjukkan bahwa 60% dokumentasi asuhan keperawatan telah memenuhi standar kualitas dengan peningkatan pengetahuan sebesar 5% setelah implementasi. Simpulan: Audit berkelanjutan dan pengembangan pelatihan perlu ditingkatkan untuk mendukung implementasi perubahan. Evaluasi berkesinambungan ini diperlukan untuk memastikan peningkatan kualitas dapat dipertahankan dan terus berkembang. Saran: Langkah konkret yang diperlukan termasuk evaluasi bulanan terhadap implementasi pendokumentasian untuk memastikan asuhan keperawatan dilakukan sesuai standar. Kata Kunci: Asuhan Keperawatan; Audit; Perubahan; Rawat Jalan.

Pengembangan pedoman handover di ruang rawat inap rumah sakit Universitas Indonesia Magdalena, Helen; Handiyani, Hanny; Pujasari, Hening; Hariyati, Roro Tutik Sri; Sari, Erna Puspita
Holistik Jurnal Kesehatan Vol. 19 No. 2 (2025): Volume 19 Nomor 2
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i2.848

Background: The handover process in nursing care is very important because it is directly related to patient safety and continuity of care. A suboptimal handover can increase the risk of medical errors. Purpose: To develop handover guidelines in the inpatient ward of the University of Indonesia Hospital. Method: A case report study on the preparation of handover guidelines was conducted at the University of Indonesia Hospital on September 2 - October 2, 2024. This activity includes assessment, data analysis, action plan (Plan of Action/PoA), implementation, and evaluation. Data collection was carried out through interviews, observations, and questionnaires. The approach used to solve the problem through Kurt Lewin's theory of change. Results: Shows that the implementation of handover is not optimal with variations in methods used, including conferences and handovers at the bedside. The results of the study indicate that the implementation of the handover SOP has not been consistently adhered to by ward nurses and several factors such as time constraints and lack of supervision have a negative effect on the effectiveness of the handover. Conclusion: The implementation of handovers in inpatient rooms has not been optimal due to inconsistencies in the application of SOPs, time constraints, and lack of supervision. The development of handover guidelines with the Kurt Lewin change theory approach is a strategic step to improve the effectiveness and consistency of handovers. Wider dissemination of guidelines and regular monitoring are needed to ensure patient safety and the quality of sustainable nursing care. Suggestion: Handover guidelines need to be updated regularly based on scientific evidence (evidence-based practice) to remain relevant to developments in nursing science. Socialization and implementation activities of handover conferences and handovers at the patient's bedside need to be monitored and evaluated routinely to ensure their effectiveness in improving the quality of patient handovers. Keywords: Handover; Guidelines; Development; Inpatient; Hospital. Pendahuluan: Proses serah terima atau handover dalam asuhan keperawatan sangat penting karena secara langsung berhubungan dengan keselamatan pasien dan kontinuitas perawatan. Handover yang tidak optimal dapat meningkatkan risiko kesalahan medis. Tujuan: Untuk mengembangkan pedoman handover di ruang rawat inap rumah sakit Universitas Indonesia. Metode: Penelitian case report mengenai pengembangan panduan handover, dilakukan di Rumah Sakit Universitas Indonesia pada 2 September – 2 Oktober 2024. Kegiatan ini meliputi pengkajian, analisis data, rencana tindakan plan of action (PoA), implementasi, dan evaluasi. Data dikumpulkan melalui wawancara, observasi, dan pengisian kuesioner. Pendekatan yang digunakan untuk menyelesaikan masalah melalui teori perubahan Kurt Lewin. Hasil: Menunjukkan bahwa pelaksanaan handover belum optimal dengan variasi metode yang digunakan, termasuk conference dan bedside handover. Hasil menunjukan bahwa pelaksanaan SPO handover tidak konsisten dipatuhi perawat ruangan dan beberapa faktor, seperti keterbatasan waktu dan kurangnya supervisi berpengaruh negatif terhadap efektivitas handover. Simpulan: Pelaksanaan handover di ruang rawat inap belum berjalan secara optimal akibat ketidakkonsistenan dalam penerapan SPO, keterbatasan waktu, dan kurangnya supervisi. Pengembangan panduan handover dengan pendekatan teori perubahan Kurt Lewin menjadi langkah strategis untuk meningkatkan efektivitas dan konsistensi handover. Sosialisasi panduan yang lebih luas dan monitoring berkala diperlukan untuk menjamin keselamatan pasien dan kualitas asuhan keperawatan yang berkelanjutan. Saran: Panduan handover perlu diperbarui secara berkala berdasarkan bukti ilmiah (evidence-based practice) agar tetap relevan dengan perkembangan ilmu keperawatan. Kegiatan sosialisasi dan implementasi handover conference serta bedside handover perlu dimonitoring dan dievaluasi secara rutin untuk memastikan efektivitasnya dalam meningkatkan kualitas serah terima pasien. Kata Kunci: Handover; Pedoman; Pengembangan; Rawat Inap; Rumah Sakit.

Transformasi strategis sistem informasi keperawatan di rumah sakit X menuju smart garden hospital Wea, Maria Eka Brigida Wonga; Septirini, Maria Indah; Suhani, Nini; Perdana, Riska Rusfita; Septianata, Viesca; Hariyati, Roro Tutik Sri
Holistik Jurnal Kesehatan Vol. 19 No. 6 (2025): Volume 19 Nomor 6
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i6.928

Background: A smart garden hospital is an approach that prioritizes not only smart technology but also environmental sustainability, patient comfort, humanization of services, and operational efficiency based on information technology. Information and communication technology supports evidence-based nursing practice, strengthens patient safety, and meets global healthcare standards. Purpose: To describe the strategic transformation of X hospital nursing information system toward a smart garden hospital. Method: The field study used a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis approach. Data were analyzed using Internal Factor Evaluation (IFE) and External Factor Evaluation (EFE) matrices, and mapped onto an Internal-External (IE) matrix to determine the organization's strategic position. Results: The analysis yielded an IFE score of 2.61 and an EFE score of 3.15, placing Hospital X in the "growth and development" quadrant, representing an organization with adequate internal strengths and strong external opportunities, making an aggressive growth strategy an appropriate choice. Conclusion: The transformation of X hospital nursing information system emphasizes the importance of a comprehensive strategy involving strengthening human resource capacity, optimizing technology, and responsive risk management. Suggestion: Hospitals can formulate strategies based on the Balanced Scorecard (BSC) perspective and key performance indicators (KPIs) linked to the TOWS strategy in developing their nursing management information systems. Keywords: Information; Hospital; Nursing; Smart Garden Hospital; Strategy; System; Transformation. Pendahuluan: Smart garden hospital merupakan sebuah pendekatan yang tidak hanya mengedepankan teknologi cerdas, tetapi juga memperhatikan keberlanjutan lingkungan, kenyamanan pasien, dan humanisasi pelayanan serta efisiensi operasional berbasis teknologi informasi. Teknologi informasi dan komunikasi untuk mendukung praktik keperawatan berbasis bukti, memperkuat keselamatan pasien, serta menjawab standar global pelayanan kesehatan. Tujuan: Untuk mendeskripsikan transformasi strategis sistem informasi keperawatan di rumah sakit X menuju smart garden hospital. Metode: Studi lapangan dengan pendekatan analisis Strength, Weakness, Opportunity, and Threat (SWOT). Data dianalisis menggunakan matriks internal faktor evaluasi (IFE) dan eksternal faktor evaluasi (EFE), serta dipetakan ke dalam matriks internal-eksternal (IE) untuk menentukan posisi strategis organisasi. Hasil: Analisis didapatkan skor IFE = 2.61 dan Skor EFE = 3.15, menempatkan rumah sakit X pada kuadran "growth and build" yang merepresentasikan organisasi dengan kekuatan internal yang cukup dan peluang eksternal yang kuat, sehingga strategi pertumbuhan agresif menjadi pilihan yang sesuai. Simpulan: Transformasi sistem informasi keperawatan rumah sakit X menegaskan pentingnya strategi komprehensif yang melibatkan penguatan kapasitas sumber daya manusia, optimalisasi teknologi, dan manajemen risiko yang responsif. Saran: Rumah sakit dapat melakukan perumusan strategis yang ditetapkan melalui perspektif balance scorecard (BSC) dan key performance indicators (KPI) yang dikaitkan dengan strategi TOWS dalam pengembangan sistem informasi manajemen keperawatan. Kata Kunci: Informasi; Keperawatan; Rumah Sakit; Smart Garden Hospital; Strategis; Sistem; Transformasi.

Strengthening the Role of Head Nurses in Managing Quality Improvement (QI) Programs for Pressure Injury Prevention in Hospitals Firmansyah, Hendra; Hariyati, Roro Tutik Sri; Rayatin, Lilis
Indonesian Journal of Global Health Research Vol 7 No 1 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i1.5322

Nursing managers face challenges in implementing Quality Improvement (QI) programs for pressure injury prevention in hospitals. Objectives: To identify problems faced by nurse managers in implementing QI programs and to develop problem-solving solutions. Mini-project on improving the quality of care room management and analysis of results and implementation gaps based on literature review. Data collection through interviews, observations, and questionnaires in the internal medicine inpatient ward. Data were analyzed using the 5 Whys technique and fishbone diagram. Problem-solving solutions used the FOCUS PDSA approach. It was found that the direction and control functions of the quality improvement program in efforts to prevent pressure injuries were not optimal. The implementation of solutions in the form of improving pressure injury data management, staff re-education, making mini posters, and evaluating the impact of pressure injuries on costs. The evaluation results showed that all at-risk patients had received preventive interventions and no new cases of pressure injuries were found. Strengthening the direction function of the head of the room through staff re-education, poster installation, and effective monitoring can improve the implementation of the QI program in preventing pressure injuries in hospitals.

Enhancing Nurses' Ethical Knowledge in Hospitals Through the Initiation of Nursing Ethic Navigation and A Nurses' Ethical Guideline E-Book Shabrina, Citra Hafilah; Yetti, Krisna; Handiyani, Hanny; Rachmi, Shanti Farida; Sari, Erna Puspita; Hariyati, Roro Tutik Sri
Indonesian Journal of Global Health Research Vol 7 No 4 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i4.6399

Nurses in hospitals often face complex ethical situations; however, there are still gaps in the understanding and application of nursing ethical principles, and a structured, easily accessible ethical guideline is not yet available. This study aims to develop two main solutions Nursing Ethic Navigation (an ethical guideline web search engine) and the Nurses' Ethical Guideline E-Book using John Kotter’s Eight-Step Change Model approach. The method used is a case study conducted at Hospital X during September–October 2024, encompassing problem identification, action planning, implementation, and evaluation. The respondents in this study were the Head Nurse, Primary Nurse, Nursing Department staff, members of the Nursing Committee, and nurses in the IGD-COT unit at Hospital X. Data were collected through interviews, observations, and questionnaires, then analyzed using problem priority scoring and a fishbone diagram to identify root causes as the basis for developing action plans and change strategies. The results showed a significant improvement in nurses’ knowledge, awareness, and ability to apply ethical principles after the intervention. Digital media such as the e-book and web-based tools proved effective as learning platforms and practical references that can be accessed anytime. This study recommends expanding the implementation of ethical guidelines to other service units, supported by managerial involvement and continuous evaluation, to ensure integration into the organizational culture and daily nursing practice.

Implementasi metode pembelajaran campuran berbasis sistem manajemen pembelajaran pada pelatihan keperawatan: A literature review Azizah, Yuni; Hariyati, Roro Tutik Sri
Holistik Jurnal Kesehatan Vol 17, No 9 (2024)
Publisher : Program Studi Ilmu Keperawata Fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v17i9.13035

Background: Technical competency nursing training is the basis for efforts to develop nurse competency, the implementation of which can be modified using the blended learning method or mixed system. The blended learning system combines face-to-face and online learning both virtual synchronously and virtual asynchronously. In accommodating virtual asynchronous learning, one of the learning technologies that can be used is a Moodle-based Learning Management System (LMS).Purpose: To provide views and descriptions of the use of the Learning Management System in nursing training using the blended learning method, analyzing the effectiveness of use, inhibiting and supporting factors, accuracy of target use, and outcomes resulting from LMS-based learning.Method: This research uses a literature review design, namely collecting and analyzing previous literature or research references that have been selected from various sources to become a conclusion on new ideas or a compilation of new ideas. The literature study selection process is based on Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). The literature used in this study is various articles discussing topics with three categories of keywords, namely learning management system (LMS); blended learning; and nursing training. Search for articles via online databases, including Scopus, ProQuest Clinical Key, Ebscohost, and Pubmed. Based on these keywords, they were input using "and" and "or" which were then filtered to produce specific literature findings by narrowing the year range, namely 2018-2023.Results: Based on a review of 10 articles, the use of LMS produces positive effects in blended learning for teachers, students or participants with good preparation and media. International literature shows that the use of Learning Management Systems (LMS) as a mode of asynchronous learning can accommodate and provide a positive impact in the development of blended learning. In its implementation, blended learning with LMS also influences the success of learning in this electronic evaluation model investigation, namely that it depends on the learning strategies used by the students themselves, the environment where the learning takes place, the teaching design brought by the teacher into the classroom, and student learning behavior.Conclusion: A Moodle-based Learning Management System is an alternative form of developing competency improvement in effective and efficient nursing practice. Support for interactive and creative learning media modifications can increase interest in learning. Keywords: Blended Learning; Learning Management System (LMS); Nursing TrainingPendahuluan: Pelatihan keperawatan teknis kompetensi menjadi dasar upaya pengembangan kompetensi perawat yang mana dalam pelaksanaannya dapat dimodifikasi dengan metode blended learning atau sistem bauran. Sistem pembelajaran blended learning menggabungkan pembelajaran tatap muka dan online baik secara sinkronus maya maupun asinkronus maya. Dalam mengakomodir pembelajaran asinkronus maya salah satu teknologi pembelajaran yang dapat digunakan adalah Learning Management System (LMS) berbasis moodle.Tujuan: Untuk memberikan pandangan dan gambaran terhadap pemanfaatan Learning Management System pada pelatihan keperawatan dengan metode blended learning, menganalisa efektifitas pemanfaatan, faktor-faktor yang menghambat dan mendukung, ketepatan sasaran penggunaan, serta luaran yang dihasilkan dari pembelajaran berbasis LMS. Metode: Penelitian ini menggunakan rancangan literature review yaitu melakukan pengumpulan dan menganalisis literatur-literatur atau referensi penelitian terdahulu yang telah dipilih dari berbagai sumber hingga menjadi sebuah kesimpulan gagasan baru atau satu kompilasi ide baru. Proses pemilihan studi literatur berdasarkan oleh Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). Literatur yang digunakan dalam studi ini adalah berbagai artikel yang membahas topik dengan tiga kategori kata kunci yakni learning management system (LMS); blended learning; dan nursing training. Penelusuran artikel melalui online database antara lain, Scopus, ProQuest Clinical Key, Ebscohost, dan Pubmed. Berdasarkan kata kunci tersebut diinput dengan menggunakan “and” dan “or” yang kemudian dilakukan penapisan untuk menghasilkan temuan literatur yang spesifik dengan mempersempit penetapan rentang tahun yaitu tahun 2018-2023.Hasil: Berdasarkan telaah 10 artikel, pemanfaatan LMS menghasilkan efek yang positif dalam pembelajaran bauran (blended learning) baik bagi pengajar, siswa atau peserta dengan persiapan dan media yang baik. Literatur internasional menunjukkan bahwa pemanfaatan Learning Management System (LMS) sebagai salah satu moda pembelajaran asinkron dapat mengakomodir dan memberikan dampak yang positif dalam pengembangan pembelajaran blended learning. Dalam Pelaksanaannya juga pembelajaran blended learning dengan LMS yang mempengaruhi keberhasilan pembelajaran dalam penyelidikan model evaluasi elektronik ini yaitu bergantung kepada strategi pembelajaran yang digunakan oleh siswa itu sendiri, lingkungan tempat pembelajaran berlangsung, desain pengajaran yang dibawa oleh guru ke dalam kelas, dan perilaku belajar siswa. Simpulan: Learning Management System berbasis moodle menjadi salah satu alternatif bentuk pengembangan peningkatan kompetensi dalam praktik keperawatan yang efektif dan efisien. Dukungan modifikasi media pembelajaran yang interaktif dan kreatif dapat meningkatkan minat pembelajaran. Kata Kunci: Blended Learning; Learning Management System (LMS); Pelatihan Keperawatan.

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